Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-03-10
- Stop
- 2016-03-10
The parties
- Patient
- patient Angelo Muller
- Provider
- provider Simon Tremblay
- Payer
- payer Humana
Record id
036bf274-5bd6-d003-b7fc-c44a4cf024c0